The Blood Lipid Profile Of Acute Coronary Syndrome Patients With LDL-C Less Than 100mg/dL

Objective: Clinical studies have shown that even when Low Density Lipoprotein Cholesterol(LDL-C) have been decreased to 100 mg/dl, th e residual risk of cardiovascular disease still exists.In clinical work, we als o found that patients with LDL-C less than 100 mg/dl still have the possib ility to get acute coronary syndrome(ACS) and these patients’ blood lipi d profile are seldom reported.This study was done to research the blood lipi d profile of ACS patients with LDL-C less than 100 mg/dl.Methods: We adopted case-control study method and continuous selec tions were conformed according to the set of standard samples.In this stud y,all the patients were divided into three groups,ACS group,stable coronar y heart disease(SCAD) group, and control group in which patients were di agnosed as non coronary atherosclerotic heart disease by coronary angio graphy after matching the sex and age.We recorded general conditions of al l the patients in three groups including age,sex,diabetes,hypertension,smok ing and alcohol intake. Moreover,we recorded blood lipid including triglyc erides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(H DL-C), low density lipoprotein cholesterol(LDL-C), apolipoprotein A1(Apo A-l), Apolipoprotein B(Apo B), Apolipoprotein E(Apo E), Lipoprotei n(a)[Lp(a)] and free fatty acids(FFA) for patients in three groups.Then w e compared the general situations and serum lipid levels among three group s.We analyzed the potential risk factors for ACS with logistic regression a nalysis and accessed its diagnostic value in the judgment of ACS with the r eceiver-operating characteristic(ROC) curve.Results: 176 patients were selected in the study divided into thre e groups:ACS group(58 cases),SCAD group(35 cases),control group(74 cases).There was no significant difference of general situations among th e three groups when compared,including age, sex, diabetes, smoking an d alcohol intake. The proportion of patients with hypertension in ACS gro up is more than that in control group(70.7% VS. 50%,P<0.05).TG,Ap o B and FFA of Patients in ACS group are more than the other two group s when compared while HDL and Apo A-1 are less.Compared with contr ol group, the logistic regression analysis showed Apo A-1 was a protectiv e factor of ACS(OR 0.034,95%CI 0.007-0.163) while age(OR 1.075, 95% CI 1.075 1.031), Apo B(OR 32.033, 95% CI 32.033 19.85) are indepen dent risk factors of ACS.Compared with SCAD group, the logistic regressi on analysis showed that the Apo A-I was a protective factor of ACS(OR 0.032, 95% CI 0.032 0.006), while Apo B is an independent risk factor of AC S(OR 24.269, 95% CI 24.269 2.017).The ROC curve of Apo B showed th e area under the curve was 0.688(95% CI 0.596 0.780).When the cut-off point of Apo B was 0.895, sensitivity was 44.8%,and the specificity was 86.5%.Conclusion: In patients with LDL-C less than 100 mg/L, perherps Ap o A-I a pathogenesis protection factor of ACS and Apo B might be an inde pendent risk factor of ACS.